The predictive value of relative wall thickness on the prognosis of the patients with ST-segment elevation myocardial infarction.
The predictive value of relative wall thickness on the prognosis of the patients with ST-segment elevation myocardial infarction.
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DOI：
10.1186/s12872-023-03379-5
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发表时间：
2023-07-31
影响因子：
2.1
通讯作者：
中科院分区：
文献类型：
--
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目的探讨相对室壁厚度（RWT）对ST段抬高型心肌梗死（STEMI）患者预后的预测价值。本研究回顾性纳入2010年11月至2018年12月南京大学医学院附属鼓楼医院收治的866例STEMI患者。RWT的计算方法有RWTPW、RWTIVS+PW和RWTIVS三种。分别根据RWTPW、RWTIVS+PW和RWTIVS的中位数对纳入的患者进行分组。采用Kaplan-Meier曲线进行生存分析，建立多变量考克斯比例风险模型，评价3种RWT对全因死亡、心源性死亡和主要心源性不良事件（MACE）的校正风险比。RWTPW、RWTIVS+PW和RWTIVS低、高剂量组之间30 d和12个月的生存分析无显著性差异。尽管如此，在60个月时，RWTPW和RWTIVS+PW的低组中全因死亡和心源性死亡的累积发生率高于高组。低RWTPW组60个月时MACE累积发生率高于高RWTPW组。多因素考克斯回归模型显示RWTPW与STEMI患者长期心源性死亡和MACE呈负相关。在亚组分析中，三种RWT计算方法对前壁心肌梗死患者无预测价值。相比之下，RWTPW是非前壁心肌梗死患者长期预后最稳定的独立预测因子。RWTPW、RWTIVS+PW和RWTIVS对前壁心肌梗死患者的长期临床结局没有预测价值，而RWTPW是非前壁心肌梗死患者全因死亡、心源性死亡和MACE的可靠预测因素。RWT是一个能用简单公式量化左心室同心度或偏心度的指标。RWT的计算方法有三种：RWTPW = 2 × PWth/LVDd; RWTIVS+PW =（IVSth + PWth）/LVDd; RWTIVS = 2 × IVSth/LVDd（IVSth：室间隔厚度; LVDd：左室舒张末期直径; PWth：后壁厚度）。从我们的研究中，我们得出结论，RWTPW，RWTIVS+PW和RWTIVS对前壁心肌梗死患者的长期临床结局没有预测价值，而RWTPW是非前壁心肌梗死患者最有效的预测因子。
The study aimed to evaluate the prognostic value of relative wall thickness (RWT) in the patients with ST-segment elevation myocardial infarction (STEMI). A total of 866 patients with STEMI admitted in Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School from November 2010 to December 2018 were enrolled in the current study retrospectively. Three methods were used to calculate RWT: RWTPW, RWTIVS+PW and RWTIVS. The included patients were divided according to the median values of RWTPW, RWTIVS+PW, and RWTIVS, respectively. Survival analysis were performed with Kaplan–Meier plot and multivariate Cox proportional hazard model was established to evaluate the adjusted hazard ratio of the three kinds of RWT for all cause death, cardiac death and MACE (major adverse cardiac death). There was no significance for the survival analysis between the low and high groups of RWTPW, RWTIVS+PW and RWTIVS at 30 days and 12 months. Nonetheless, the cumulative incidence of all cause death and cardiac death in the low group of RWTPW and RWTIVS+PW was higher than those in the high group at 60 months. The cumulative incidence of MACE in the low group of RWTPW was higher than the high group at 60 months. Multivariate Cox regression model showed that RWTPW were inversely associated with long-term cardiac death and MACE in STEMI patients. In the subgroup analysis, three calculations of RWT had no predictive value for the patients with anterior myocardial infarction. By contrast, RWTPW was the most stable independent predictor for the long-term outcomes of the patients with non-anterior myocardial infarction. RWTPW, RWTIVS+PW and RWTIVS had no predictive value for the long-term clinical outcomes of patients with anterior myocardial infarction, whereas RWTPW was a reliable predictor for all cause death, cardiac death and MACE in patients with non-anterior myocardial infarction. RWT is an index which can quantified the concentricity or eccentricity of the left ventricular using a simple formula. There are three methods to calculate RWT: RWTPW = 2 × PWth/LVDd; RWTIVS+PW = (IVSth + PWth)/LVDd; RWTIVS = 2 × IVSth/LVDd(IVSth: intraventricular septal thickness; LVDd: LV diameter at the end of diastole; PWth: posterior wall thickness). From our study we concluded that RWTPW, RWTIVS+PW and RWTIVS had no predictive value for the long-term clinical outcomes of patients with anterior myocardial infarction, whereas RWTPW was the most effective predictor of patients with non-anterior myocardial infarction.
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影响因子：
24
作者：
Pedersen, Frants;Butrymovich, Vitalij;Jorgensen, Erik
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通讯作者：
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